Although we have just begun 2013, many are already focused on 1/1/14. That is when more provisions of the Patient Protection and Affordable Care Act (commonly called Obamacare) go into effect. In 2014 new provisions kick in that will prohibit Health Insurance companies from charging higher rates for individuals with pre-existing medical conditions.

No longer will health insurance companies be allowed to discriminate (i.e. underwrite) based on medical conditions. And no longer will health insurance companies require Underwriters to determine the risk of various maladies.

If you are a Health Underwriter then you will most likely need to reposition yourself. As with all Underwriters, hopefully you have been keeping up with your continuing education. If you have taken LOMA courses then you have been exposed to all the basic Life Insurance concepts. If you have attended WAHLU seminars then you have been informed of new trends in the industry. And if you kept updated by reading On the Risk and Hank’s Hot Notes then you are ready to reposition yourself as a Life Underwriter.

I can speak from experience about the transition from Health Underwriter to Life Underwriter. After working as a Health Underwriter for 8 years, I switched to Life Underwriting. Instead of being concerned with the cost of every health condition, I was only concerned with those conditions that impact mortality. Of course there were new concerns related to insurable interest, replacements, and financial underwriting.

Can you go from Health to Life Underwriting? To give yourself the best chance, take time now to do some things for yourself. Sign up for Hank’s Hot Notes – it’s free. Become a basic Member of AHOU for $50 and receive On the Risk. Plan to attend the WAHLU Seminar on April 23rd. Go online and start a LinkedIn account to connect with others in our industry. Finish work on a designation. And you can still sign up to take an ALU exam until March 1st.

Now is the time to take inventory of your skills and determine what you can do for yourself. See you in April!

It is always worthwhile to revisit Asthma in underwriting guideline. There always seems to be a trend to rate depending on the classification – i.e., Mild intermittent, mild, moderate, or severe persistent. Classification is also based on the number or type of medications being used. I suggest the medical evidence invites a different approach that would result in applicants being rated in a fairer manner. The death rates for asthma are down in general. The interesting fact for me is that deaths are not directly related to the asthma classification, but rather to the asthma control no matter what the classification. To maintain adequate control requires multiple medications at times - including combination therapies and always including a steroid medication. I suggest that these histories should not be a reason to rate, but rather to give credit to the applicant and then apply the extra ratings to any classification of asthma that shows poor control. Poor control would be indicated by regular use of a rescue inhaler( albuterol ) , frequent clinic, hospital or emergency room visits, and lack of home monitoring through a peak flow meter or other self- monitoring asthma scores.

I’d like to share a recent example of this. An Underwriter asked my opinion about an applicant with a moderate persistent asthma diagnosis coupled with use of an Advair inhaler (combination steroid and long-acting beta –agonist). Based on the guidelines a rating seemed appropriate. I suggested that the medication choice and other parameters in the history showed great control and therefore did not warrant a rating. Although a rating has been traditionally assigned to this group, it is important to look at asthma control and not just medications when classifying. And this is a good thing for our applicants with good control of their asthma and good for the agent and the company as well.

Anti-Trust Statement: It is the policy of the Wisconsin Association of Health and Life Underwriters (WAHLU) that its members must at all time comply with both the letter and the spirit of anti-trust laws. Broadly stated, these laws prohibit any activities that might lessen or tend to lessen desirable competition among insurance companies.